Citizen Involvement

Mercy Corps is starting up programs in the North African country of Tunisia for the first time.

Waving the Tunisian flag during protests earlier this year. Photo: courtesy of gwenflickr, Flickr.com

Tunisia stands at a crossroads following the dramatic events leading to the January 14, 2011, overthrow of President Ben Ali. As the euphoria of the revolution subsides, the country faces important decisions on what comes next. Tunisian citizens want more meaningful engagement in the political processes that govern their lives.

Mercy Corps recognizes how important civil society engagement is to Tunisia's future. Our first program aims to enhance civic education and the influence of women and youth leadership in citizen organizations. As the country undergoes reform, there will be many new opportunities for women and young people to participate and represent their interests and points of view. Working in close partnership with the Center of Arab Women for Training and Research (CAWTAR) and the Fédération Tunisienne des Clubs UNESCO-ALECSO (FTCUA), the program will:

• Help 30 national, regional and local organizations to engage women, youth and their communities in civic projects
• Increase the capacity of youth organizations to advocate and network to address key social, political and economic issues
• Develop and increase youth awareness and engagement through the Global Citizen Corps approach, so that 225 young Tunisians can learn the leadership skills and civic knowledge necessary to help shape their new environment

CAWTAR has extensive experience building the capacity of a wide variety of community service organizations, as well as expertise to help address the gender issues that will be a key to success in building a Tunisia-owned civil sector. Likewise, FTCUA also has important expertise and a long history of working with Tunisian youth. They have the capability to deepen youth engagement in the country.

Young people comprise 50 percent Tunisia's population. They represent a particularly important constituency in Tunisia’s transition because of the role they played in the revolution, their rapidly growing numbers and their lack of representation in government. Likewise, women, whose role in civil society was similarly constrained during the Ben Ali regime, will also be important participants in the reform process.

Tunisia’s revolution marked the beginning of this year’s dynamic Arab Spring. We’re confident that, with help from our accomplished local partners, we can help youth, women and other committed Tunisian citizens continue that spirit of change and transform their country for the better.

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A pathway through the village of Los Mangales, Guatemala, with the Tienda de Salud sign at right. Photo: Lindsay Murphy/Mercy Corps

Los Mangales is a collection of humble one-room huts with sporadic electricity and dusty rows of beans and corn outside. Amid the lush and verdant banana and coffee trees in Guatemala's central highlands, it seems like any other sleepy village -- except for the placard on the side of the road that reads Tienda de Salud: a Health Store.

Since that sign went up two years ago, residents have avoided the grueling and costly two-hour round-trip to the nearest town to purchase basic medicines, first-aid supplies and other health products. Before, many avoided seeking preventative health services due to the high cost and inconvenience — risking greater complications for otherwise treatable illnesses. But today, thanks to Mercy Corps' Sustainable Community Health Stores program, there exists a hometown alternative.

Filling a health gap

Guatemala is a poor country — especially in rural areas. More than half of its residents lives in poverty, and 60 percent do not have access to the most basic education or health care. Living conditions in rural areas are even worse, where malnutrition and mortality rates are exacerbated by the lack of health services.

Francisco and his wife stand by the sign that announces their Tienda de Salud — a health store and micro-pharmacy — in the village of Los Mangales, Guatemala. Photo: Lindsay Murphy/Mercy Corps

Historically, the Guatemalan government and local charities have offered health programs to rural communities. But those services are often focused exclusively on young women and children below the age of five, leaving much of the population without adequate access to medicine or health care.

Sustainable Community Health Stores is a new way of addressing the rural healthcare problem. It helps local families start small businesses while providing much-needed medicines in communities like Los Mangales.

Empowering local entrepreneurs

Francisco was the first participant in the health stores program. Like other business owners, he had previously worked as a health promoter in his village. Through Mercy Corps' tutelage and technical assistance, he learned basic business planning and bookkeeping and received a small seed loan to provide start-up capital for the store.

Francisco opened his Los Mangales store in June 2009, stocking it with drugs such as anti-inflammatories, antibiotics, vitamins and some common household items like soap and diapers. The "Tienda de Salud" sign points to his house; he built a tiny storefront addition from which he runs the business. Residents say the products he offers are higher quality than what's offered nearby.

Opening a store can be a risk, but it can also be as profitable as any other available job nearby. Thanks to what he'd learned and a strong work ethic, Francisco was able to repay his initial loan in only 11 months -- seven months ahead of schedule.

"Owning a business comes with responsibility, not only to my family but for the betterment of my village," Francisco says.

A microfranchising model based on a private-sector partnership

To give rural villages access to the same medicines as their urban counterparts, Mercy Corps developed a microfranchising model with Farmacias de la Comunidad, a generics-only drugstore chain with over 400 stores throughout Guatemala.

The inside of a typical village Tienda de Salud, supported by Mercy Corps' Sustainable Community Health Stores program, with various health products and medications stocked on the shelves. Photo: Lindsay Murphy/Mercy Corps

Each store owner is given financing, a defined logistical chain and pricing, and marketing support to promote their products and better health practices in their community. Financial support comes from Linked Foundation, a U.S.-based enterprise committed to improving the health and economic self-reliance of women in Latin America.

These entrepreneurs build a vital social enterprise that improves the well-being of their families and provides jobs in their communities — and helps their neighbors stay healthy.

"This private-sector partnership model is a lasting way to give families in rural Guatemala access to medicines that can prevent serious illness," says Stephanie Skillman, the project manager for Mercy Corps.

More stores are on the way. Skillman says the hope is to open 30 by year's end. The result will be more small pharmacies run by entrepreneurs like Francisco -- and more lifelines to families in remote communities like those in Los Mangales.

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A community home-based volunteer counsels a client during her home visits in Mbare, Harare, Zimbabwe. A Mercy Corps-led consortium is is providing HIV services to poor and vulnerable households in urban areas. Photo: courtesy of Zimbabwe Project Trust

Florence Tigere is in bed today. The typically vibrant 55-year-old woman, who serves as both treasurer and secretary of her HIV Sahwira Support Group, is suffering from a piercing headache. The severe pain, coupled with Florence’s swollen face and feet, has community home-based volunteer Mary Musamba concerned.

“Please take your mother to the hospital immediately,” Mary advises Florence’s 17-year-old daughter, giving her 50 cents of her personal money to pay for transport. Mary is worried Florence may have contracted a type of meningitis or possibly malaria. In either case, she needs treatment right away, especially because Florence’s immune system is already compromised by the HIV.

The importance of early medical referrals is one of the many reasons the Joint Initiative for Urban Zimbabwe (JI) — a consortium of ten non-governmental organizations (NGOs) places a strong focus on community home-based care. The consortium, which is led by Mercy Corps, is providing HIV services to poor and vulnerable households in urban areas — including delivery of free home-based care to more than 8,578 clients in six urban areas of Zimbabwe.

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From left, Mercy Corps veteran Middle East staff leader Andy Dwonch, Nir Oren, Mercy Corps Founder Dan O'Neill and Rami Elhanan. Photo: Mercy Corps

A couple of days ago I shared Turkish coffee with two Israeli men who dare to cross traditional barriers in confronting violence and retaliation through dialogue and understanding. The Parents' Circle is an organization touching thousands of lives for good. "We are all about bringing bereaved Israeli and Palestinian families together for reconciliation and Peace," said Rami Elhanan.

Rami — son-in-law of the legendary Israeli Army General, Matti Peled — lost his 14 year old daughter, Smadar, to a suicide bomber on September 4, 1997. It was a national news event for Israel and a shattering loss to family and friends.

Rami's friend and partner Nir Oren, General Manager of The Parents' Circle, shares a similar tragedy. His 60-year-old mother was killed on a Tel Aviv bus by a suicide bomber 16 years ago.

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The people living in Masokut were very enthusiastic about the installation of a hydraulic pump, which helps getting clean water easier for tsunami-affected families. Photo: Iswanto JA/Mercy Corps

Thanks to the Bill & Melinda Gates Foundation, Mercy Corps´ hygiene promotion, livelihood, water and sanitation programs are improving living conditions for those living in displacement camps on Indonesia's Mentawai Islands, which were struck by a tsunami last October. In the villages of Masokut and Berilou village on the island of Sipora, these programs are having a positive effect on the community´s health and economic wellbeing.


The head of Masokut village, Rahmat Setiawan, told Mercy Corps that people in his community have started to smile because of the success of the water and sanitation programs. "Before Mercy Corps' water and sanitation program, people took water from the small river that is around 100 meters behind the relocation camp. Carrying the bucket without spilling all of the water was difficult and tiring day in and day out. Every day, parents and children must take turns to bring water 100 meters home," said Rahmat.

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Fumie Sugawara (in glasses) plays a colorful game with young tsunami survivors at Kesennuma Middle School. Photo: Christopher Cabatbat/Mercy Corps

Fumie Sugawara sits on the blue tarpaulin that's spread across the floor the gymnasium. A bright yellow truck and other vibrant toys are gathered around her. Fumie engages two young girls in an imaginative game using a dozen different shades of Play-Doh.

She has always found herself drawn to art and expression through colors. Colors helped Fumie make it through a personal crisis years ago, when she was a young university student in the United States. They helped her choose pursuit of an Art Therapy degree. And today, they're helping her bring creative therapeutic play to young tsunami survivors as part of Mercy Corps' Comfort for Kids program here in northeastern Japan.

Fumie grew up in the city of Kesennuma, which was hit hard by March's disastrous earthquake and tsunami. She attended Kesennuma Middle School, which is now being used as an evacuation center and temporary shelter for families that lost their homes. That's where today's Comfort for Kids activity is taking place: in the very same gymnasium where she played games as a young girl.

Things have come full circle for Fumie — all the way from here in Japan to Wisconsin and back. She earned her Master of Science degree in Art Therapy at Mount Mary College in Milwaukee, a perfect melange of her interests in colors, education and psychology. Then she worked as a therapist in the United States for seven years, before going home to Kesennuma in February.

From "hopeless" to helpful

When the earthquake and tsunami struck less than a month later, Fumie was far from her hometown of Kesennuma. She was traveling with her mother when they heard the horrific news, and because public transit was down, couldn't get back to Kesennuma until two days later. Thankfully, her family was all right. But her city was in bad shape. Hundreds of people had lost their homes, and the needs were overwhelming.

The sprawl of blue tarpaulins and stark white tents inside the gymnasium of Kesennuma Middle School, a place that several dozen families have called home for nearly three months now. Photo: Christopher Cabatbat/Mercy Corps

"To be honest, when the disaster hit, at first I felt helpless and hopeless," Fumie explains. "I was already out of work, with nothing to do, so I went to the local volunteer center. What they wanted were hands to sort things out — anything. So I said, 'Here, let me do it.'"

"But what I really wanted to do was art therapy for displaced children and families. I kept coming in and expressing my background, which was initially hard for people to understand — we don't really have that in Japan," she continues. "But then they asked me to go and see about the needs at the evacuation centers, and see if there was anything I could do about it. That’s how this started, and that's how I started working with Peace Winds (Mercy Corps' partner).”

Since then, she's been busy helping develop the Comfort for Kids program, continuing to visit evacuation centers like this and connecting with young survivors through art, sports and other fun activities. Almost three months after the tsunami ended or shattered thousands of lives, Fumie sees so many needs — for children and adults alike.

“Mostly, kids here are keeping their experience and grief to themselves,” she explains. "Art is such a safe communication — it creates distance from things that are painful or uncomfortable. And play is a powerful medium for children to explore what they've experience and what they're feeling. Comfort for Kids provides the space, time and materials — and play partners — to help them do that.”

The girl with red eyes

Fumie then remembers one young girl that she recently met at one of the evacuation centers.

Photo: Christopher Cabatbat/Mercy Corps

"We were doing an art exercise with several children. 'Draw anything you want,' I said. The kids said, ‘I can draw this’ and showed me pictures of pretty things like dresses," she recalls. "Then something happened when they got off by themselves. When they came back, one girl showed me a picture she’d drawn of a girl in a dress with red eyes — really red. Then she quietly folded it, embarrassed. She didn’t want to show anyone. So we put it in an envelope for safe keeping until she’s ready to show it.

"This girl has stayed in a community center just after the tsunami, trapped with no food or water until they were rescued two days later by helicopter. She saw fire. She saw explosions.”

Fumie pauses, and then keeps describing her interaction with the young girl that day.

“I asked her, ‘What do you want at this moment?’ She said, ‘A house’,” Fumie says. “We have to listen to what they say. When they try to express themselves, we give them the chance without us changing their story at all. We create a safe environment. We repeat what they say so they can process what they need to say.

“So I told her, ‘We cannot bring back your house, but here’s what we can provide.’ It’s okay to tell them what we can control and what we cannot control.”

Therapy for survivors of all ages

It's not just children who feel like their world is out of control — their parents are feeling enormous stress as well.

“Adults get to the point where they can’t control the chaos anymore," Fumie explains. "Children are able to sort it out, like blocks, through play. We want to give kids that time and space so adults can have their time and space as well.”

Cheerful, creative, indomitable spirits like Fumie's are helping disaster-affected children rediscover play and happiness despite hard times. Photo: Christopher Cabatbat/Mercy Corps

Psychosocial needs here in northeastern Japan have no age limit. That's why Fumie is working hard alongside her Peace Winds and Mercy Corps colleagues to develop programs that help any survivors who seek therapy and the chance to explore their feelings.

“We have to provide more specific programs for all age groups, both children and adults. Even the elderly, to facilitate healthy communication between generations,” she says.

The world of northeastern Japan's evacuation centers is dominated by big blue tarpaulins, stark white tents and the uncertainty of what comes next for thousands of survivors. But with help from Mercy Corps and Peace Winds, Fumie Sugawara is bringing brightness, lightness and caring support back into hundreds of lives.

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Temporary housing for tsunami-displaced families in the devastated city of Rikuzentakata. Photo: Christopher Cabatbat/Mercy Corps

Right now, the city of Rikuzentakata, Japan is a food desert — a place where it's nearly impossible to find and buy fresh, nutritious food. Grocery stores and other shops were washed away by the tsunami. The closest markets are at least a half-hour away by car.

But most of the cars in Rikuzentakata were destroyed in the disaster. And most of the public transit — local trains and buses —remains at a standstill, stranding those who depended on that means of transport. In this place, hundreds of families are living in schools and other public buildings, as well as prefabricated temporary housing. They're mostly dependent on the food that comes in as donations from charities or kind individuals: supplies like instant noodles, canned goods and bottled water.

Three months after the tsunami, what survivors really want to do is purchase and prepare their own food. Mercy Corps and partner Peace Winds are helping survivors do just that — many for the first time since the disaster — through a mobile grocery store run by a 40-year-old local businessman named Takanori Nakano.

Takanori Nakano. Photo: Christopher Cabatbat/Mercy Corps

Nakano lost his store to the tsunami, but was lucky enough to keep his house. He's currently sheltering 10 friends and family members who weren't as fortunate. You can see the mixture of stress and determination in Nakano's expression as he speaks.

His shop was a glass-engraving business that specialized in pieces for special occasions like weddings and graduations. He had only started it last June, and had just won a big contract with a local school district, when everything he'd built was taken by the waves.

But — even in the immediate aftermath of the disaster — Nakano had an idea about how he could not only support his family, but also help families around his devastated hometown. So he went to the Rikuzentakata Chamber of Commerce with two pieces of business: seeing what they could do about restoring his ruined business and asking if they'd be interested in helping him start a kind of mobile supermarket.

Turns out that great minds really do think alike: Peace Winds and Mercy Corps had already approached the Chamber of Commerce with a similar idea. Just like that, Nakano had a new job — although it wasn't that easy to get things started in the midst of a disaster zone.

Mercy Corps helped find and purchase a refrigerated truck, which we then donated to the Chamber of Commerce. Nakano got to work figuring out food suppliers and a daily work schedule that would fit his family's needs as well as offer flexibility and good service for customers. He opened for business on May 16.

Nakano's wife sells food from the mobile grocery store. Photo: Christopher Cabatbat/Mercy Corps

The day we visited him, he was doing a brisk business selling to families in the evacuation center and temporary housing at one of Rikuzentakata's school. Customers formed a long, excited line to see what he had to offer. Everyone seemed to walk away happy.

It was his third day of sales. I asked him what he had been hearing from his customers.

"People are really enjoying being able to shop instead of receiving things," he said. "And I'm asking them what they'd like to see more or less of. They're saying they want more fresh fish and meat.

"They're very happy to see fruit and vegetables, though," he continued. "Someone said it was like the first time they saw water finally coming out of a pipe again — it's amazing to them."

But, according to Nakano, there are challenges in keeping such a business going.

"Right now, I'm getting my inventory from just one place, a regular store in Ofunato. I don't have the storage space or refrigeration to buy wholesale right now, because it's just not available around here," he explained. "So I have to buy things every morning and hopefully sell them that day. I'm only charging a 10 percent markup to customers, which is enough to cover my costs and make a little money to help my family."

Customers are "very happy to see fruit and vegetables...it's amazing to them," Nakano told us. Photo: Christopher Cabatbat/Mercy Corps

He paused before offering his next thought.

"My purpose right now isn't necessarily about being successful, it's about helping people."

And with that, he's off to help more eager customers. It might not be what he wants to do for the rest of his life — but, for now, Takanori Nakano's mobile grocery store is a little oasis in the midst of a food desert.

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Expectant mothers and mothers-in-law at a focus group discussion in Gonchi district, Tajikistan Photo: Mercy Corps Tajikistan

I’m back in Tajikistan, six months after my first visit. This time, I’m here to support our field team with the midterm evaluation being conducted for our Maternal and Child Health program. Accompanying me is Donna Sillan, a consultant we have contracted to write the evaluation.

We spent our first two days in Khujand — in the country's northern Sughd region where most of Mercy Corps' Maternal and Child Health interventions are taking place — planning sessions with the Village District Coordinators on how to collect qualitative data to gain an understanding of the program’s impact on improving the health of women and children in the target areas, as well as other local capacity-building initiatives. The Village District Coordinators are a mix of Tajik men and women, many of them trained doctors from the Soviet era. These people are not only knowledgeable of health issues, but genuinely care about the work they are doing in the communities.

As I saw them conduct trainings, focus group discussions and various interviews with our beneficiaries, their support came across in such a kind and nurturing manner that made me think —even if I had never met them — I would feel immediately comfortable in speaking to them about my health!

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My name is Martha Muñoz. I was born and raised in Medellin, Colombia: the land of Juan Valdéz and Conchita, the donkey! Coffee coffee! My elementary and high school education was received in Colombia. The rest has been in the U.S. — I have attended and graduated from The University of Massachusetts Boston, the National College of Natural Medicine in Portland, Oregon and currently, I am a candidate for a Masters in Public Health at Oregon's Portland State University.

Now, I am volunteering with Mercy Corps Guatemala's PROCOMIDA project — and, in doing so, I am fulfilling one of my lifelong dreams of working with undeserved communities and working with a multidisciplinary team.

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The women who call themselves "4H," whose names each begin with the letter "H." Their collective volunteer efforts have reached more than 2,500 Mercy Corps beneficiaries. Photo: Haoua Sidibé/ Mercy Corps

The name "4H" is really a pure coincidence: these four colleagues from the same Mercy Corps project in Niger are called Hadiza, Halima, Hadiara and Hadiza. They told me about their efforts to support hundreds of women in Niamey, as well as their desire to make changes amongst the most marginalized, yet motivated populations.

Through the Urban Economic Opportunities Extension Project, 4H support exactly 2,557 persons including 2,456 women. Their target group, usually comprised of women of very low education levels, includes household women, who have become small business entrepreneurs.

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